Excluding prepontine cistern from whole ventricle radiotherapy target volume in localized germinoma

• 영문명: Excluding prepontine cistern from whole ventricle radiotherapy target volume in localized germinoma
• 발행기관: 대한방사선종양학회
• 저자명: Hyejo Ryu Joo Ho Lee
• 간행물 정보: 『대한방사선종양학회지』제41권 제1호, 48~57쪽, 전체 10쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2023.03.30

영문 초록

Purpose: The target delineation of whole ventricle radiotherapy (WVRT) in germinoma varies among radiation oncologists, especially regarding the inclusion of the prepontine cistern (PC). We evaluated the outcome of PC-sparing WVRT in localized germinoma. Materials and Methods: We identified 87 localized intracranial germinoma patients who received radiotherapy (RT) following chemotherapy between 1999 and 2020. By institutional policy, RT for localized germinoma excluded PC from the target volume. WVRT was delivered to 65 patients (74.7%) and involved field radiotherapy (IFRT) to 22 patients (25.3%). The median dose was 45.0 Gy (range, 23.4 to 55.8 Gy) for the primary tumor and 19.8 Gy (range, 14.4 to 36.0 Gy) for the whole ventricle. We analyzed the dosimetric differences of the organs at risk between the PC-excluding plans and the PC-including ones. Results: The median follow-up duration was 7.8 years (range, 1.0 to 22.5 years). The 10-year recurrence-free survival and overall survival rates were 86.3% and 90.9%, respectively. The recurrences occurred in eight patients (8.7%), including five patients after IFRT and three after WVRT. Five of them showed recurrences at lateral ventricles and only one patient experienced spinal cord relapse. However, no relapse in the PC occurred. Endoscopic third ventriculostomy was not a significant prognostic factor. The dosimetric comparisons showed significantly lower mean doses to the brainstem and the cochleae when the PC was excluded. Conclusion: WVRT for localized germinoma can safely exclude the PC in the target volume, reducing radiation dose to the brain stem. The target protocol needs to reach a consensus regarding the PC in prospective trials.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

References

키워드

Radiotherapy Cerebral ventricle Germinoma